Midkine levels and its relationship with atherosclerotic risk factors in essential hypertensive patients.

BACKGROUND AND OBJECTIVES: Hypertension (HT) is one of the risk factors associated with atherosclerosis. Midkine (MK) plays a role as a growth factor in various biologic and pathologic events. In some reports, MK expression has been shown to be linked with vascular smooth muscle proliferation and neo-angiogenesis in atherosclerotic vessels. The aim was to research relationship of MK serum levels with some atherosclerotic risk factors in hypertensive patients. METHODOLOGY: This study examined 60 patients with essential HT and 30 healthy controls. Serum biochemistry, including lipid profile, MK, Vitamin B12, C-reactive protein, zinc and copper levels were obtained. RESULTS: MK levels of the HT patients were significantly higher than the control group (24.8 ± 6.8 ng/mL vs. 18.39 ± 5.6 ng/mL, respectively, P < 0.01). Lipid profile parameters such as total cholesterol, triglyceride, low-density lipoprotein (LDL) were also significantly higher in HT patients (P < 0.021, P < 0.01, and P < 0.01, respectively). Zinc levels were 179.13 ± 34.06 µg/dL and 172.55 ± 45.47µg/dL in the HT and control group, respectively. Serum MK levels were positively correlated with diastolic (r = 0.288, P < 0.05) and systolic blood pressures (r = 0.390, P < 0.002), and also with serum total cholesterol (r = 0.406, P < 0.002) and LDL cholesterol (r = 0.318, P < 0.015) levels. Furthermore MK was also negatively correlated with zinc and Vitamin B12levels (r = -0.298, P < 0.023, r = -0.334, P < 0.027, respectively). CONCLUSION: This study has demonstrated an important association between increased serum MK levels and risk factors of atherosclerosis such as HT, increased total and LDL cholesterol.

Retrospective evaluation of patients at follow-up with acute poisoning in Intensive Care Unit.

OBJECTIVE: Poisonings are among the major causes of emergency visits and intensive care hospitalizations. The aim of our study is to evaluate intoxicated patients at follow-up and treated in the Intensive Care Unit (ICU) in terms of demographic characteristics, type of poisonings and results of treatment. MATERIALS AND METHODS: Patients at follow-up aged 17 or older admitted with intoxication to the ICU between January 1, 2009 and December 31, 2011 were included in the study. Age, gender, presenting symptoms, duration of hospitalization, type of poisoning, the way of poisoning, medical history, seasons, hospitalization costs, treatment and prognosis of the patients were analyzed. RESULTS: Totally, 153 (8.9%) out of 1375 follow-up patients in the ICU had acute intoxication. The mean age of intoxicated patients was 29.4 ± 11, 68% of them were female, 78.4% of them were under 35 years old, and intoxication was most common in the 17-25 age group. 114 of them (94.1%) were suicidal. The most common cause of poisoning was drug-poisoning by 88.2%, and most common presenting symptoms were nausea and vomiting by 71.2%. Mean length of stay was 2.4 ± 1.6 days, and the average cost of hospitalization was 761 ± 884 Turkish Liras or 271 ± 315 USD. 5 patients (3.3%) were intubated because of respiratory failure. There was no mortal case. CONCLUSION: Suicide attempts are prominent in acute poisoning, and the young female population is at higher risk. It was found that drugs, particularly antidepressants and antipsychotic agents were the most common cause of poisoning. The high cost of treatment of acute intoxication cases is a major cause of economic burden. Clinicians should be more careful when prescribing such drugs.

Nutritional status and laboratory parameters among internal medicine inpatients.

BACKGROUND: Malnutrition is a clinical state resulting in prolonged hospital stay, increase in severity of infections and poor wound healing. AIMS: Our aim was to investigate the prevalence and etiologic factors of malnutrition in medical inpatients. STUDY DESIGN: A total of 290 consecutively admitted internal medicine patients from February to May 2012 were included. On admission, demographic data, anthropometric measurements, laboratory parameters and nutritional screening test results were recorded. METHODS: Nutritional risk score-2002 for patients under 65 years old, mini nutritional assessment for older patients and subjective global assessment (SGA) tests performed. Relation of demographic characteristics, laboratory parameters, weight and body mass index (BMI) with nutritional status were evaluated. RESULTS: Mean age was 61±17 years; 145 patients were male. Among 160 patients<65 years old, 34 were in malnutrition (21%), 41 (26%) were under risk of malnutrition and 85 (53%) were normal. When they were divided into three groups according to SGA, we found significant difference in hemoglobin, low density lipoprotein (LDL), high density lipoprotein, cholesterol, triglyceride, albumin and protein, weight and BMI. Among 130 patients over 65 years old, 47 patients (37%) were in malnutrition, 41 (31%) were under risk of malnutrition and 42 (32%) were normal. There was significant difference in LDL, cholesterol, albumin, protein, weight and BMI between three groups; each 1 g/dl decrease in serum albumin and age older than 65 years old increased malnutrition risk 5.21 and 1.97 times, respectively. CONCLUSION: Malnutrition risk is high among internal medicine inpatients and risk seems to be higher among older patients. Nutritional screening of geriatric patients, close follow-up and providing earlier health care would contribute rehabilitation of chronic diseases and decrease re-admissions.

Mean platelet volume is associated with glycaemic control and retinopathy in patients with Type 2 Diabetes Mellitus / Volumen medio de plaquetas está asociado con el control glucémico y la retinopatía en pacientes con Diabetes Mellitus Tipo 2

OBJECTIVES: To investigate the relationship between mean platelet volume (MPV) and glycometabolic indices, to compare MPV according to HbA1c levels, and to analyse the difference in MPV between patients with and without microvascular complications. METHODS: This retrospective study was conducted on 60 Type 2 diabetic patients and 50 age- and sex-matched non-diabetic controls. We obtained demographic, clinical and laboratory data including MPV, platelet count, fasting and postprandial blood glucose (FBG and PBG), haemoglobin A1c (HbA1c), lipid profile, creatinine, systolic and diastolic blood pressure (BP) in patient and control groups, and diabetic microvascular complications including nephropathy, neuropathy, and retinopathy in the patient group. All analyses were performed using SPSS version 15.0 for Windows. RESULTS: Mean platelet volume in the diabetic group was higher than in the control group (p = 0.001). Mean platelet volume was positively correlated with FBG and HbA1c levels (p = 0.03 and p < 0.001, respectively). It was also negatively related to platelet count (p < 0.001). Mean platelet volume in patients with HbA1c > 7% was significantly higher than those with HbA1c < 7% (p < 0.001). Mean platelet volume was significantly increased in patients with retinopathy compared to those without retinopathy (p = 0.04). CONCLUSION: This study has shown that an increased MPV is closely associated with poor glycaemic control, which may be a risk factor for diabetic retinopathy. Nonetheless, further prospective studies are needed to assess the relationship between MPV, glycaemic indices and microvascular complications.

OBJETIVOS: Investigar la relación entre el volumen medio de plaquetas (MPV) y los índices glicometabólicos, comparar el MPV según los niveles de HbA1c, y analizar la diferencia de MPV entre los pacientes con y sin complicaciones microvasculares. MÉTODOS: Este estudio retrospectivo se realizó en 60 pacientes diabéticos tipo 2, y 50 controles no diabéticos pareados por sexo y edad. Obtuvimos datos demográficos, clínicos y de laboratorio - incluyendo MPV, conteo de plaquetas, glucosa en sangre en ayunas (FBG) y postprandial (PBG), hemoglobina A1c (HbA1c), perfil lipídico, creatinina, presión arterial (BP) sistólica y diastólica en los grupos de pacientes y de control, así como complicaciones microvasculares diabéticas, incluyendo nefropatía, neuropatía y retinopatía en el grupo de pacientes. Todos los análisis se realizaron utilizando el SPSS versión 15.0para Windows. RESULTADOS: El volumen medio de plaquetas en el grupo diabético fue superior al del grupo control (p = 0,001). El volumen medio de plaquetas guardó una correlación positiva con el FBG y los niveles de HbAlc (p = 0.03 y p < 0.001, respectivamente). También se observó una correlación negativa con el conteo de plaquetas (p < 0.001). El volumen medio de plaquetas en los pacientes con HbA1c > 7% fue significativamente mayor que en aquellos con HbAlc < 7% (p < 0.001). El volumen medio de plaquetas aumentó significativamente en los pacientes con retinopatía en comparación con aquellos sin retinopatía (p = 0,04). CONCLUSIÓN: Este estudio mostró que el aumento de MPV está estrechamente relacionado con un control glicémico pobre, lo cual puede ser un factor de riesgo para la retinopatía diabética. Sin embargo, otros estudios prospectivos son necesarios para evaluar la relación entre MPV, los índices glicémicos, y las complicaciones microvasculares.

Mean platelet volume is associated with glycaemic control and retinopathy in patients with type 2 diabetes mellitus.

OBJECTIVES: To investigate the relationship between mean platelet volume (MPV) and glycometabolic indices, to compare MPV according to HbA1c levels, and to analyse the difference in MPV between patients with and without microvascular complications. METHODS: This retrospective study was conducted on 60 Type 2 diabetic patients and 50 age- and sex-matched non-diabetic controls. We obtained demographic, clinical and laboratory data including MPV, platelet count, fasting and postprandial blood glucose (FBG and PBG), haemoglobin A1c (HbA1c), lipid profile, creatinine, systolic and diastolic blood pressure (BP) in patient and control groups, and diabetic microvascular complications including nephropathy, neuropathy, and retinopathy in the patient group. All analyses were performed using SPSS version 15.0 for Windows. RESULTS: Mean platelet volume in the diabetic group was higher than in the control group (p = 0.001). Mean platelet volume was positively correlated with FBG and HbA1c levels (p = 0.03 and p < 0.001, respectively). It was also negatively related to platelet count (p < 0.001). Mean platelet volume in patients with HbA1c > 7% was significantly higher than those with HbA1c ≤ 7% (p < 0.001). Mean platelet volume was significantly increased in patients with retinopathy compared to those without retinopathy (p = 0.04). CONCLUSION: This study has shown that an increased MPV is closely associated with poor glycaemic control, which may be a risk factor for diabetic retinopathy. Nonetheless, further prospective studies are needed to assess the relationship between MPV, glycaemic indices and microvascular complications.